Quality of life in patients with multidrug-resistant tuberculosis under programmatic condition using World Health Organization's Quality of Life Brief instrument: A case-control study

Objective: To evaluate and compare the quality of life (QoL) in patients with multidrug-resistant (MDR-TB) and drug-sensitive (DS-TB) as well as to investigate factors associated with QoL among MDR-TB patients in real-world scenarios at the Haji Hospital, Surabaya. Methods: We conducted a case-control study from June to December 2024. MDR-TB and DS-TB patients were classified into case and control groups, respectively. We used the World Health Organization’s Quality of Life Brief (WHOQOL-BREF) instrument and Patient Health Questionnaire-9 (PHQ-9) to assess QoL and depression levels, respectively. Multivariate analysis was used to analyze factors associated with QoL of patients with MDR-TB. Results: Forty-one patients with MDR-TB and 43 with DS-TB were enrolled in the study. A mean score for all domains (physical, psychological, social relationship, environmental) and total mean score of WHOQOL-BREF was significantly lower in MDR-TB than those with DS-TB ( P <0.05). The prevalence of depression and the mean score of PHQ-9 were significantly higher in MDR-TB than in DS-TB ( P <0.05). PHQ-9 negatively correlates with the WHOQOL-BREF score ( r =-0.502, P <0.05) among MDR-TB patients. MDR-TB patients with depression were significantly associated with low QoL in the physical (OR 3.611; 95% CI 2.393-6.951; P =0.029), psychological ( OR 1.672; 95% CI 1.179-5.941; P =0.021), social relationship ( OR 2.586; 95% CI 1.611-2.909; P =0.014), and environmental domains ( OR 1.926; 95% CI 1.047-2.147; P =0.048). Conclusions: MDR-TB patients had worse QoL than DS-TB. Those with depression were associated with low QoL. Strategies that identify and tackle alterations in the QoL for MDR-TB patients are necessary during TB treatment.